{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:14:20Z","timestamp":1747149260416,"version":"3.40.5"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T00:00:00Z","timestamp":1694822400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare safety and effectiveness of two\u2010different directions of suturing the posterior vaginal breach (horizontal [Ho] vs vertical [Ve]) in women undergoing recto\u2010vaginal endometriosis (RVE) nodule resection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A multicenter, retrospective, observational, cohort study was performed including all women of reproductive age undergoing RVE nodule resection between March 2013 and December 2018 at our tertiary centers. Patients included in the present study were divided into two groups based on the direction in suturing the posterior vaginal fornix defect, for comparisons in terms of rate of postoperative complications, pain relief, pain and anatomical recurrence, and length of hospital stay. Univariate comparisons were performed adopting the <jats:italic>t<\/jats:italic> test or the Mann\u2013Whitney test for continuous data and the chi\u2010square test or the Fisher exact test for categorical data, with a significant <jats:italic>P<\/jats:italic> value set to &lt;0.05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 101 women were included: 67 in the Ho\u2010group and 34 in the Ve\u2010group. The two groups did not significantly differ in length of hospital stay (6.7\u2009\u00b1\u20096.9 vs 6.6\u2009\u00b1\u20093.3\u2009days; <jats:italic>P<\/jats:italic>\u2009=\u20090.95), overall postoperative complications (32.8% vs 14.7%; <jats:italic>P<\/jats:italic>\u2009=\u20090.05), pain recurrence (35.8% vs 26.5%; <jats:italic>P<\/jats:italic>\u2009=\u20090.34) and anatomical recurrence rate (19.4% vs 23.5%; <jats:italic>P<\/jats:italic>\u2009=\u20090.62). Conversely, grade III complications were significantly more common in the Ho\u2010group than in the Ve\u2010group (22.7% vs 20%, <jats:italic>P<\/jats:italic>\u2009=\u20090.009), while pain relief in terms of deep dyspareunia, dyschezia, dysuria and chronic pelvic pain was more consistent in the Ve\u2010group patients (<jats:italic>P<\/jats:italic>\u2009=\u20090.04, 0.04, 0.05, 0.004, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In symptomatic women undergoing RVE nodule resection, Ho suturing of the vaginal breach appears more commonly associated with severe postoperative complications and a worse pain control.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.15109","type":"journal-article","created":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T07:53:52Z","timestamp":1694850832000},"page":"550-556","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Horizontal versus vertical direction of posterior vaginal wall\u00a0suture after eradication of rectovaginal endometriosis: A\u00a0multicenter study"],"prefix":"10.1002","volume":"164","author":[{"given":"Luigi Carlo","family":"Turco","sequence":"first","affiliation":[{"name":"Ovarian Cancer Center, Candiolo Cancer Institute, FPO\u2010IRCCS  Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego","family":"Raimondo","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Human Reproduction Physiopathology IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5443-2333","authenticated-orcid":false,"given":"Antonio","family":"Raffone","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Human Reproduction Physiopathology IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"},{"name":"Department of Medical and Surgical Sciences (DIMEC) University of Bologna  Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivano","family":"Raimondo","sequence":"additional","affiliation":[{"name":"Gynecologic and Obstetric Unit, Department of Medical, Surgical and Experimental Sciences University of Sassari  Sassari Italy"},{"name":"Gynecology and Breast Care Unit, Mater Olbia Spa  Olbia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virginia","family":"Vargiu","sequence":"additional","affiliation":[{"name":"Department of Medicine and Health Science \"V.Tiberio\" Universit\u00e0 Degli Studi del Molise  Campobasso Italy"},{"name":"Gynecologic Onocology Unit, Gemelli Molise SpA  Campobasso Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arianna","family":"Raspollini","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Human Reproduction Physiopathology IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"},{"name":"Department of Medical and Surgical Sciences (DIMEC) University of Bologna  Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Travaglino","sequence":"additional","affiliation":[{"name":"Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Pathology Unit Fondazione Policlinico Universitario A. 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Gemelli, IRCCS  Rome Italy"},{"name":"Universit\u00e0 Cattolica del Sacro Cuore Facolt\u00e0 di Medicina e Chirurgia  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renato","family":"Seracchioli","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Human Reproduction Physiopathology IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"},{"name":"Department of Medical and Surgical Sciences (DIMEC) University of Bologna  Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Casadio","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Human Reproduction Physiopathology IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Scambia","sequence":"additional","affiliation":[{"name":"Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica UOC Ginecologia Oncologica, Fondazione Policlinico Universitario A. 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